Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Apr;25(2):126-131.
doi: 10.1097/MOT.0000000000000743.

Development of a UK liver transplantation selection and allocation scheme

Alexander Gimson  1
Affiliations
Review

Development of a UK liver transplantation selection and allocation scheme

Alexander Gimson. Curr Opin Organ Transplant. 2020 Apr.

Abstract

Purpose of review: Equitable allocation of organs for liver transplantation remains a major area of ongoing study. In United Kingdom, it was agreed that the success of any national donor offering scheme would be judged from the point of registration on a national list for a transplant, and would therefore include outcome while waiting for the procedure.

Recent findings: Standard minimal criteria for acceptance onto a transplant list have been developed for chronic liver disease, hepatocellular carcinoma and for a number of variant syndromes where current scores do not adequately reflect the risk of death without a transplant or symptom burden. Allocation by need, or on the basis of utility, or by transplant benefit (net life years gained) were compared in a simulation against current unit-based allocation. A transplant benefit model was shown to reduce deaths on the waiting list and maximise population life years.

Summary: Since March 2018, liver donors after brain death in United Kingdom have been offered to a national list prioritised by net life years gained - transplant benefit.

PubMed Disclaimer

References

    1. Barber K, Madden S, Allen J, et al. United Kingdom liver transplant selection and allocation working party elective liver transplant list mortality: development of a United Kingdom end-stage liver disease score. Transplantation 2011; 92:469–476.
    1. Schaubel DE, Guidinger MK, Biggins SW, et al. Survival benefit based deceased-donor liver allocation. Am J Trans plant 2009; 9 (pt 2):970–981.
    1. Duvoux C, Roudot-Thoraval F, Decaens T, et al. Liver transplantation for hepatocellular carcinoma: a model including alpha-fetoprotein improves the performance of Milan criteria. Gastroenterology 2012; 143:986–994.
    1. Cillo U, Burra P, Mazzaferro V, et al. Consensus-based approach to organ allocation in liver transplantation: toward a ‘blended principle model’. Am J Transplant 2015; 15:2552–2561.
    1. Toso C, Dupuis-Lozeron E, Majno P, et al. A model for dropout assessment of candidates with or without hepatocellular carcinoma on a common liver transplant waiting list. Hepatology 2012; 56:149–156.

Publication types